关键词: 肝结核, 磁共振成像, 体层摄影术, 扩散加权成像

Abstract: Objective To analyze the clinical and imaging features of 20 patients with hepatic tuberculosis (TB).Methods The clinical data and imaging materials of 20 patients with hepatic TB hospitalized in Fifth Medical Center of PLA General Hospital from January 2009 to April 2021 were analyzed retrospectively, the sex, age, main complaints, body temperature, clinical manifestations, laboratory examinations and imaging features were summarized.Results In 20 patients with liver TB, fever, fatigue and abdominal distension were the main symptoms. Laboratory examination showed that all tumor markers were negative in 12 cases, with 7 cases of CA125 increased, 2 cases of CA199 increased, and 1 case of CA153 increased. 14 cases of computed tomography (CT) or magnetic resonance (MR) showed nodules or mass-like lesions, 2 cases showed spot or spot pattern, the focal length was between 0.60 cm to 18.10 cm, 14 cases showed mild circular or uneven enhancement, irregular separation and division-like enhancement was seen in 10 cases, and 13 cases showed delay progressive enhancement. Increased abdominal lymph nodes were seen in 12 patients, and massive recurrent intrahepatic lesion was identified after surgery in 1 patient.Conclusion Hepatic TB is more common in middle-aged and elderly men. Fever, fatigue and abdominal distension were the main complaints. Some patients may havd elevated tumor markers. Most of the imaging findings were single or multiple nodules or patches, enlarged abdominal lymph nodes. Most enhancement scans show circular progressive enhancement, and some of them could have mutual fusion and separation enhancement, and some patients may recur.Imaging examination combined with liver pathological examination was the main diagnosis of hepatic TB.

Key words: Hepatic tuberculosis, Magnetic Resonance Imaging, Tomography, Diffusion-weighted imaging